Validity of the Dysexecutive Questionnaire (DEX). Ratings by patients with brain injury and their therapists

Abstract

Objective: This study investigated the validity of the DEX-Questionnaire (both completed by patients, DEX-Self and by therapists, DEX-TH), included in the Behavioural Assessment of the Dysexecutive Syndrome (BADS), at identifying differences in the severity of dysexecutive symptoms according to lesion location. It also examined the strength of associations of the DEX-Self and the DEX-TH reports with the sub-tests of the BADS as well as two other real-life executive tasks, the Everyday Description Task and the Twenty Question Test.

Methods: This study compared 30 patients with anterior lesions (AL) to 22 patients with posterior lesions (PL). Twenty-nine healthy participants and their relatives were included as controls.

Results: Significant group differences were found only on the DEX-TH, but not on the DEX-Self, indicating poor insight in patients with AL. The DEX-TH were revealed accurate in detecting more severe dysexecutive symptoms in the AL group. Furthermore, only the DEX-TH reportings were significantly correlated with the above executive tests. Multiple regression analysis showed that the Modified Six Elements Test, a sub-test of the BADS, predicted DEX-TH as accurately as the total BADS.

Conclusion: The DEX-TH reportings and the MSET can provide valuable information about the severity of daily executive dysfunctioning, with implications for cognitive rehabilitation.

• Ecological validity
• executive functioning
• frontal lobes
• head injury
• neuropsychological assessment

Acknowledgements

The authors thank all the participants and their therapists as well as the healthcare institutions that participated in this study: Rehabilitation Center ‘Anagennisi’ (Nea Redestos, Thessaloniki, Greece), Saint Lukas Clinic (Panorama, Thessaloniki, Greece).